Consent for Procedure:

Below are links to consent forms for procedures. The consent form(s) applicable to your procedure must be signed on the day of surgery. The forms are listed alphabetically by procedure name as well as by form name.


Consent forms Alphabetized by Procedure Name:

Form “C-A” • Abscess Skin Incision and Drainage consent form

Form “C-B” • Adenoidectomy consent form

Form “C-AL” • Biopsy with Skin Incision consent form

Form “C-E” • Branchial Cleft Cyst consent form

Form “C-F” • Bronchoscopy consent form

Form “C-G” • Cervical Lymphadenectomy (Neck Dissection) consent form

Form “C-L” • Drug Induced Sleep Endoscopy (DISE) consent form

Form “C-AV” • Ear Canal Surgery consent form

Form “C-I” • Ear Examination Under Anesthesia and Possible Tympanostomy Tube Placement or Removal consent form

Form “C-D” • Eyelid Surgery consent form

Form “C-J” • Esophagoscopy consent form

Form “C-K” • Excision of Malignancy consent form

Form “C-AW” • Foreign Body Removal (upper airway & digestive tract) consent form

Form “C-AP” • Foreign Body Removal (via skin) consent form

Form “C-AU” • Frenulectomy consent form

Form “C-M” • General (incisional) consent form

Form “C-AT” • Hematoma Evacuation consent form

Form “C-AX” • Injection Laryngoplasty consent form

Form “C-AM” • Inspire Implant consent form

Form “C-P” • Laryngoscopy consent form

• Form “C-R” • Nasal endoscopy, possible biopsy, cautery, packing

Form “C-H” • Nasal Fracture Closed Reduction consent form

Form “C-T” • Osia implant consent form

Form “C-AQ” • Otoplasty consent form

Form “C-V” • Panendoscopy (Direct Laryngoscopy, Esophagoscopy, Bronchoscopy) With Possible Biopsy consent form

Form “C-W” • Parathyroidectomy consent form

Form “C-X” • Parotidectomy consent form

Form “C-O” • Photo consent form

Form “C-Z” • Rhinoplasty with or without Septoplasty, and with or without Turbinate Reduction consent form

Form “C-C” • Sentinel Node Biopsy consent form

Form “C-AA” • Septoplasty and Turbinate Reduction consent form

Form “C-AC” • Sinus Endoscopy and Possible Excision of Nasal Lesion consent form

Form “C-AB” • Sinus Surgery with or without Septoplasty, and with or without Turbinate Reduction consent form

Form “C-AD” • Skin or Subcutaneous Excision, including Graft or Local Flap consent form

Form “C-AE” • Submandibular Gland Excision consent form

Form “C-AF” • Thyroglossal Duct Cyst Excision consent form

Form “C-AG” • Thyroidectomy consent form

Form “C-N” • Thyroplasty, medialization implantation consent form

Form “C-AH” • Tonsillectomy/Adenoidectomy consent form

• Form “C-BA” • Tracheal/Subglottic Dilation consent form

Form “C-AY” • Tracheostomy consent form

Form “C-AO” • Transoral Abscess Drainage consent form

Form “C-AR” • Transsphenoidal Approach to Pituitary consent form

Form “C-AN” • Tympanoplasty/Myringoplasty consent form

Form “C-AJ” • Tympanostomy tube placement consent form

Form “C-AK” • Tympanostomy Tube Placement plus Tonsillectomy and/or Adenoidectomy consent form

Form “C-AZ” • Zenker’s Diverticulum consent form

Form “C-AS” • Zygomaticomalar Complex Fracture Repair consent form

Consent forms Alphabetized by Form Name:

Form “C-A” • Abscess Skin Incision and Drainage consent form

Form “C-B” • Adenoidectomy consent form

Form “C-C” • Sentinel Node Biopsy consent form

Form “C-D” • Eyelid Surgery consent form

Form “C-E” • Branchial Cleft Cyst consent form

Form “C-F” • Bronchoscopy consent form

Form “C-G” • Cervical Lymphadenectomy (Neck Dissection) consent form

Form “C-H” • Nasal Fracture Closed Reduction consent form

Form “C-I” • Ear Examination Under Anesthesia and Possible Tympanostomy Tube Placement or Removal consent form

Form “C-J” • Esophagoscopy consent form

Form “C-K” • Excision of Malignancy consent form

Form “C-L” • Drug Induced Sleep Endoscopy (DISE) consent form

Form “C-M” • General (incisional) consent form

Form “C-N” • Thyroplasty, medialization implantation consent form

Form “C-O” • Photo consent form

Form “C-P” • Laryngoscopy consent form

Form “C-R” • Nasal endoscopy, possible biopsy, cautery, packing

Form “C-T” • Osia implant consent form

Form “C-V” • Panendoscopy (Direct Laryngoscopy, Esophagoscopy, Bronchoscopy) With Possible Biopsy consent form

Form “C-W” • Parathyroidectomy consent form

Form “C-X” • Parotidectomy consent form

Form “C-Z” • Rhinoplasty with or without Septoplasty, and with or without Turbinate Reduction consent form

Form “C-AA” • Septoplasty and Turbinate Reduction consent form

Form “C-AB” • Sinus Surgery with or without Septoplasty, and with or without Turbinate Reduction consent form

Form “C-AC” • Sinus Endoscopy and Possible Excision of Nasal Lesion consent form

Form “C-AD” • Skin or Subcutaneous Excision, including Graft or Local Flap consent form

Form “C-AE” • Submandibular Gland Excision consent form

Form “C-AF” • Thyroglossal Duct Cyst Excision consent form

Form “C-AG” • Thyroidectomy consent form

Form “C-AH” • Tonsillectomy/Adenoidectomy consent form

Form “C-AJ” • Tympanostomy tube placement consent form

Form “C-AK” • Tympanostomy Tube Placement plus Tonsillectomy and/or Adenoidectomy consent form

Form “C-AL” • Biopsy with Skin Incision consent form

Form “C-AM” • Inspire Implant consent form

Form “C-AN” • Tympanoplasty/Myringoplasty consent form

Form “C-AO” • Transoral Abscess Drainage consent form

Form “C-AP” • Foreign Body Removal (via skin) consent form

Form “C-AQ” • Otoplasty consent form

Form “C-AR” • Transsphenoidal Approach to Pituitary consent form

Form “C-AS” • Zygomaticomalar Complex Fracture Repair consent form

Form “C-AT” • Hematoma Evacuation consent form

Form “C-AU” • Frenulectomy consent form

Form “C-AV” • Ear Canal Surgery consent form

Form “C-AW” • Foreign Body Removal (upper airway and digestive tract) consent form

Form “C-AX” • Injection Laryngoplasty consent form

Form “C-AY” • Tracheostomy consent form

Form “C-AZ” • Zenker’s Diverticulum consent form

• Form “C-BA” • Tracheal/Subglottic Dilation consent form